OPTIMIZING OUTCOMES IN PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY

Abstract

In developing countries rheumatic heart disease (RHD) still awaits to beeliminated. It remains as is one of the leading causes of cardiac morbidity andmortality. Mitral valve is the most frequently afflicted valve in rheumatic heart2 disease. Mitral valve area reduces to 1.5cm it should be considered as seversand intervention should be planned early. Trans Esophageal echocardiography(TEE) offers unrestricted access to evaluate appendage and should be performedin all patients being considered for intervention. Symptoms of Mitral Stenosis canbe effectively mitigated by controlling heart rate regardless of patient being insinus rhythm or atrial fibrillation.PTMC) is safe, effective and durable procedure. Carefulselection of valves and patients - Intervene early - low Wilkins Score. All patientsmust be screened for LA/LAA thrombus. It is a patient friendly procedure.Patients who derive maximal benefit are young, females, pregnant, those whorequire repeat procedure after CMV or PTMC and those who have contraindications to general anesthesia. It has documented salutary acute and longterm results. One has to have supervised training to learn to avoid complications.LV function may be compromised therefore LV function shall be monitordiligently.